Nokea
A client is receiving an alkylating agent. Which of the following would be used?
- A. Bleomycin (Blenoxane)
- B. Chlorambucil (Leukeran)
- C. Vinblastine (Velban)
- D. Cyclophosphamide (Cytoxan)
- E. Ifosfamide (Ifex)
Correct Answer: B,D,E
Rationale: Alkylating agents make the cell a more alkaline environment, leading to cell damage. Alkylating agents include chlorambucil (Gliadel), cyclophosphamide (Cytoxan), and ifosfamide (Ifex). Bleomycin is classified as an antineoplastic antibiotic. Vinblastine is a plant alkaloid.
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A client has been diagnosed with cancer. The physician prescribes antineoplastic drug therapy to the client. Which of the following would the nurse include in the discussion about the prescribed therapy?
- A. Leads to complete cure of cancer
- B. Destroys only cancerous cells
- C. Provides complete relief of symptoms of cancer
- D. Delays spread of cancer to other sites
Correct Answer: D
Rationale: The nurse should explain to the client that antineoplastic drugs delay the spread of cancer to other sites in the body. These drugs do not always lead to the complete cure of cancer; instead, they slow the growth of the tumor. Antineoplastic drugs destroy not just cancerous cells but all rapidly dividing cells, which may be noncancerous also. These drugs do not provide complete relief from symptoms of cancer but can help in controlling the symptoms.
The nurse is providing care to a client with anorexia due to antineoplastic therapy. The nurse identifies a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Offering fatty foods to stimulate the taste buds
- B. Providing small, frequent meals
- C. Avoiding exposure to unpleasant smells
- D. Providing foods that are high in protein
Correct Answer: A
Rationale: Greasy or fatty foods and unpleasant sights, smells, and tastes should be avoided. Small, frequent meals and foods that are high in protein are appropriate.
A client is receiving cisplatin. Based on the nurse's understanding that this drug can be nephrotoxic, the nurse anticipates that the primary health care provider will prescribe which of the following?
- A. Mesna
- B. Leucovorin
- C. Dexrazoxane
- D. Amifostine
Correct Answer: D
Rationale: Amifostine binds with the metabolites of cisplatin to protect the kidneys from the nephrotoxic effects. Mesna would be used with ifosfamide to protect the bladder from hemorrhagic cystitis. Leucovorin is used to provide folic acid to the cells after methotrexate administration. Dexrazoxane is a cardioprotective agent used with doxorubicin.
After teaching a group of nursing students about the cell cycle and how it relates to antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which phase of the cell cycle as being affected by antimetabolites?
- A. S phase
- B. M phase
- C. G2 phase
- D. G1 phase
Correct Answer: A
Rationale: Antimetabolite drugs are substances that incorporate themselves into the cellular components during the S phase of cell division. This interferes with the synthesis of RNA and DNA, making it impossible for the cancerous cell to divide into two daughter cells. The vinca alkaloids interfere with amino acid production in the S phase and formation of microtubules in the M phase. Taxanes also interfere in the M phase with microtubules. Cells are stopped during the S and G2 phases by the podophyllotoxins and thus are unable to divide. DNA synthesis during the S phase is inhibited by camptothecin analog drugs such as topotecan (Hycamtin).
A nurse is discussing the possible adverse reactions that may occur with antineoplastic therapy. Which of the following would the nurse discuss as examples of long-term adverse reactions?
- A. Fertility problems
- B. Thrombocytopenia
- C. Leukopenia
- D. Stomatitis
- E. Cardiotoxicity
Correct Answer: A,E
Rationale: Fertility problems, cardiotoxicity, pulmonary toxicity, and neurologic problems are examples of long-term reactions to an antineoplastic drug that the nurse should discuss with the client prior to drug administration. Thrombocytopenia, leukopenia, and stomatitis are more immediate adverse reactions.